Is there any maximum coverage limitation?

Yes. The calendar year annual maximum is $3,000 per person; per year (excludes Orthodontics).

How do I pay for services?

If your visit is for covered preventive care, like a routine exam, cleaning, or x-ray, there is no charge for the procedure. For other procedures, a small copayment may be required. See your Schedule of Benefits for amounts. You pay copayments directly to the dentist.

What if I need a Specialty Dentist?

Should you need a Specialty Dentist (i.e., Endodontist, Oral Surgeon, Orthodontist, Periodontist, Prosthodontist, Pediatric Dentist), you may be referred by your Participating General Dentist. Copayment amounts are applicable when treatment is performed by a Participating Specialty Dentist subject to the plan's limitations and exclusions. Procedures not listed on the schedule of benefits, that are performed by a Participating Specialty Dentist, will be charged at that Participating Specialty Dentist's usual and customary fee less 20%.

How do I make appointments?

Making an appointment is easy. Simply call the office of the Participating Provider on or after the date you receive your certificate of coverage to schedule an appointment.

Must I choose a primary provider?

No preselection of dentist is required, therefore, you may be treated by any dentist within the Advantage Plus Plan network. Benefits are available to members who receive care from in-network providers only.

What if I go to a non-participating dentist?

You will not be eligible for benefits. You must receive treatment from a Participating Provider.

How can I get more information?

You can contact Customer Care at 800-342-5209. They can assist you with information about your plan, or obtaining emergency services.